Introduction: Borderline resectable cholangiocarcinoma (CCA) carries a poor prognosis because many patients cannot undergo curative surgery. Following the approval of gemcitabine–cisplatin–durvalumab (GCD) in advanced biliary tract cancer, this real-world study evaluated its role as neoadjuvant therapy to improve resectability in borderline resectable CCA.
Introduction:
Borderline resectable cholangiocarcinoma (CCA) carries a poor prognosis because many patients cannot undergo curative surgery. Following the approval of gemcitabine–cisplatin–durvalumab (GCD) in advanced biliary tract cancer, this real-world study evaluated its role as neoadjuvant therapy to improve resectability in borderline resectable CCA.
Why was this study needed?
Results:
Clinical Impact:
This real-world experience suggests that gemcitabine–cisplatin–durvalumab is a feasible and well-tolerated neoadjuvant strategy for carefully selected patients with borderline resectable cholangiocarcinoma. The encouraging conversion-to-resection rate supports further prospective evaluation, while the heterogeneous pathological responses highlight the need for predictive biomarkers to optimize patient selection.
Bottom Line:
Neoadjuvant gemcitabine–cisplatin–durvalumab converted nearly half of borderline resectable cholangiocarcinoma patients to curative surgery and was associated with improved survival in those successfully resected. These findings support further investigation of immunotherapy-based neoadjuvant approaches in biliary tract cancer.
Introduction: Immune checkpoint inhibitors have revolutionized the treatment of dMMR/MSI-H rectal cancer, but most patients worldwide continue to receive total neoadjuvant therapy (TNT) as standard care. This international real-world study evaluated whether mismatch repair (MMR)...
Introduction: Immune checkpoint inhibitors (ICIs) are the standard first-line treatment for MSI-H/dMMR metastatic colorectal cancer (mCRC). In the absence of direct head-to-head trials, this reconstructed individual patient data (IPD) analysis compared nivolumab–ipilimumab, nivolumab, and pembrolizumab...
Introduction: Immune checkpoint inhibitors (ICIs) have transformed the treatment of microsatellite instability-high/deficient mismatch repair (MSI-H/dMMR) metastatic colorectal cancer (mCRC). While pembrolizumab and nivolumab are established treatment options, recent evidence has raised interest in dual checkpoint...
Introduction: Neuroendocrine liver metastases (NELM) are a major determinant of morbidity and mortality in patients with neuroendocrine neoplasms. Over the past three decades, advances in imaging, systemic therapies, radionuclide treatment, and liver-directed interventions have expanded...
Introduction: Pathological complete response (pCR) following neoadjuvant therapy is considered a favorable prognostic marker in esophageal adenocarcinoma. However, whether patients achieving pCR derive similar long-term benefit regardless of the neoadjuvant regimen remains uncertain. This multicenter...
Introduction: Circulating tumor DNA (ctDNA) has emerged as a promising noninvasive biomarker for monitoring treatment response and residual disease in solid tumors. However, its prognostic value during neoadjuvant chemotherapy (NAC) for localized pancreatic ductal adenocarcinoma...
We are pioneers in clinical intelligence, dedicated to helping gastroenterologists harness the power of artificial intelligence to drive precision, efficiency, and patient growth.